JACK 1 FOUNDATION INC. (NPI# 1396157681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396157681 |
| Entity Type | Organization |
| Organization Name | JACK 1 FOUNDATION INC. |
| Other Organization Name | GOLDEN TRIANGLE ADULT DAY CARE |
| Practice Address |
235 Procter St. Port Arthur TX 77640 |
| Practice Telephone | 4099845720 |
| Practice Fax Number | 4099845720 |
| Mailing Telephone | 4099845720 |
| Mailing Fax Number | 4099845720 |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |
| Authorized Official Name | MS. JUDYETTE JACKSON (FOUNDER/DIRECTOR) |
| Authorized Official Telephone | 4097197003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Golden Triangle Adult Day Care | Doing Business As Name - Organization |
| Street Address |
235 PROCTER ST. |
| City | PORT ARTHUR |
| State | TX |
| Zip Code | 77640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275031676 | Grupo Segovia Sc | Specialist | 101 Calle Primera Sur, Adolfo Lopez Mateos, Cozumel, QUINTANA ROO 77640 | 2018-01-31 |
| 1811495575 | Total Care Medical, Pllc | Clinic/Center | 8035 Memorial Blvd Ste B, Port Arthur, TX 77640 | 2018-01-29 |
| 1750805586 | Bv Continuing Care Center Ltd. Co. | Skilled Nursing Facility | 8595 Medical Center Blvd., Port Arthur, TX 77640 | 2017-08-02 |
| 1053840561 | Centro Medico De Cozumel Sa De Cv | General Acute Care Hospital | Calle 1ra Sur No. 101 Adolfo Lopez Mateo, Cozumel, QUINTANA ROO 77640 | 2017-06-08 |
| 1306391719 | Hector Trevino | Dentist | 2780 Fm 365, Port Arthur, TX 77640 | 2016-08-16 |
| 1316325616 | Gulfside Dental Port Arthur Pllc | Dentist | 2780 Hwy 365, Suite C, Port Arthur, TX 77640 | 2015-05-07 |
| 1962894782 | Chris Hale | Specialist/Technologist, Other | 6361 Katy Av, Port Arthur, TX 77640 | 2015-03-03 |
| 1205275054 | Gulf Coast Health Center, Inc | Clinic/Center | 601 Rev Ransom Howard, Bldg B, Port Arthur, TX 77640 | 2013-06-14 |
| 1285909432 | Costamed | General Acute Care Hospital | Calle Primera Sur No. 101, Cozumel, QR 77640 | 2012-03-20 |
| 1093941544 | Lindsay Denice Shafer | Audiologist | 2501 Jimmy Johnson Blvd Ste 306, Port Arthur, TX 77640 | 2009-06-10 |
| Find all providers in zip 77640 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801064076 | The Hughen Center, Inc. | Clinic/Center | 2849 9th Ave, Port Arthur, TX 77642-3961 | 2008-02-11 |
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| 1376150847 | Siempre Unidos Adult Day Care, LLC | Clinic/Center | 6600 N Val Verde Rd Ste F, Donna, TX 78537-3833 | 2020-09-28 |
| 1215541230 | Angeles Adult Day Care, LLC | Clinic/Center | 4100 W 3 Mile Rd, Suite 12, Mission, TX 78574-6177 | 2020-09-08 |
| 1023626868 | Givens Some Love Day Habilitation Center | Clinic/Center | 301 Sth 7th Street, Mabank, TX 75147 | 2020-07-17 |
| 1154939189 | Friends Place Adult Day Services | Clinic/Center | 1960 Nantucket Dr, Richardson, TX 75080-3354 | 2020-07-15 |
| 1033727060 | Friends Place Southwest LLC | Clinic/Center | 1232 W Belt Line Rd, Desoto, TX 75115-3738 | 2020-07-15 |
| 1922625243 | Teri Lynn Roberts | Clinic/Center | 13328 1/2 Almeda Rd, Houston, TX 77045-6628 | 2020-07-02 |
| 1730706326 | Bellaire Adult Day Care LLC | Clinic/Center | 7403 S Kirkwood Rd, Houston, TX 77072-3301 | 2020-06-29 |
| 1356966220 | Jalba Investments LLC | Clinic/Center | 604 E Ramon Ayala Dr, Hidalgo, TX 78557-2627 | 2020-06-16 |
| Find all providers with the same taxonomy | ||||
| City | PORT ARTHUR |
| Zip Code | 77640 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.